Individual
DR. TIMOTHY RYAN SOUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1090 ARNOLD DR, LITTLE ROCK AFB, AR 72099-4933
(501) 987-7338
Mailing address
1090 ARNOLD DR, LITTLE ROCK AFB, AR 72099-4933
(501) 987-7338
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
202201
AR
Other
Enumeration date
09/18/2019
Last updated
08/22/2022
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